Re:The U.S. could slash health-care costs with two fundament...
by js2 on Tuesday November 12, 2019 @03:20PM
(#21517715)
Looking at Singapore is a bit disingenuous. They have both public and private systems, with the private system being vastly more expensive. The public system costs are regulated. (Other differences: adult obesity in Singapore is below 10%. In the U.S. it's 40%. 65+ population in Singapore was 9% in 2010. In the U.S. 65+ population was 13% in 2010. Singapore has a population < 6M.)
If I were starting from scratch I'd go with single-payer but given where we are, it seems easier to get to a Bismarck-style regulated multi-payer system like Germany or most recently, Switzerland:
Still, Singapore is an interesting system. The craziest thing about the U.S. is how many different systems we have: the V.A. is effectively a Beveridge system, Medicare is an NHI model, Medicaid is a weird Federal/State hybrid, then we have private insurance, and on top-of-that, out of pocket. There are vested interests throughout. It's 18% of our GDP. It's going to be hard to fix. I think Medicare as a public option with subsidies is a good start. Doctors and hospitals are not going to be happy with the reimbursement rates though.
https://en.wikipedia.org/wiki/Healthcare_in_Singapore
http://assets.ce.columbia.edu/pdf/actu/actu-singapore.pdf
https://www.vox.com/policy-and-politics/2017/4/25/15356118/s...
https://www.nytimes.com/2017/10/02/upshot/what-makes-singapo...
If I were starting from scratch I'd go with single-payer but given where we are, it seems easier to get to a Bismarck-style regulated multi-payer system like Germany or most recently, Switzerland:
https://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/...
Still, Singapore is an interesting system. The craziest thing about the U.S. is how many different systems we have: the V.A. is effectively a Beveridge system, Medicare is an NHI model, Medicaid is a weird Federal/State hybrid, then we have private insurance, and on top-of-that, out of pocket. There are vested interests throughout. It's 18% of our GDP. It's going to be hard to fix. I think Medicare as a public option with subsidies is a good start. Doctors and hospitals are not going to be happy with the reimbursement rates though.